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Attitudes and understanding of complementary and alternative medicine in cancer care:An exploratory study of patients’perspectives in Karachi,Pakistan

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Asian Pacific Journal of Tropical medicine 2023年第9期16卷 400-408页

作者： Shahlla Imam Muneeba Aijaz Wajiha Iffat Shazia Qasim Jamshed Nahlah Elkudssiah Ismail Ganesh Sritheran Paneerselvam Khang Wen Goh Long Chiau Ming Halima Sadia Iqbal Azhar Department of Pharmacognosy Faculty of Pharmacy and Pharmaceutical SciencesUniversity of KarachiSindh 75270Pakistan Department of Pharmacognosy Institute of Pharmaceutical SciencesJinnah Sindh Medical UniversityKarachiSindh 75510Pakistan Department of Pharmaceutics Dow College of PharmacyDow University of Health SciencesKarachiSindh 75270Pakistan Clinical Pharmacy and Practice Faculty of PharmacyUnivesiti Sultan Zainal Abidin(UNISZA)Besut22200TerengganuMalaysia Malaysian Academy of Pharmacy Puchong 47160SelangorMalaysia Clinical Pharmacy and Pharmacy Practice Unit Faculty of PharmacyAIMST University08100 BedongKedahMalaysia School of Pharmacy Taylor’s UniversitySunway CityMalaysia Faculty of Data Science and Information Technology INTI International University71800 NilaiMalaysia School of Medical and Life Sciences Sunway University47500 Sunway CityMalaysia Department of Pharmacy Practice Faculty of PharmacyJinnah Women UniversityKarachiPakistan

Objective:To evaluate the prevalence and types of complementary and alternative medicine(CAM)modalities among patients with cancer in Karachi,Pakistan.Methods:This descriptive cross-sectional study was conducted from March 2021 to December 2021.Five hundred patients with cancer were invited to participate in the study.Electronic databases,namely,Google scholar,Publons,EMBASE,PubMed,Chinese National Knowledge Infrastructure Database,and ResearchGate was used for questionnaire designed.The self-administered survey included questions on demographic characteristics,education level,socio-economic conditions and information about CAM therapies,prevalence,effectiveness,and common CAM modalities.Statistical analysis was conducted using SPSS software version 22.Results:Out of the 500 invited patients,433(86.6%)successfully completed and returned the questionnaires.In contrast to patients who were with younger,highly educated,professionally active,higher income,and had advanced cancer,time since diagnosis,type of treatment,cancer types and family history are significantly associated with CAM use.The results showed that 59.8%of the participants were acquainted with complementary and/or alternative medicine and considered safe owing to its natural ingredients.The prevalence of CAM usage among cancer patients was 40.9%and the most widely used CAM modality was herbal medicine(27.7%)and dietary supplements(28.8%).Patients used CAM as a complementary therapy to improve the morphological parameter(28.2%),strengthen the immune system(6.8%),and to decrease the side effects of conventional treatment(18.1%).Most of the respondents get the information regarding CAM therapy from the electronic media(43.2%)and the family members(48%)rather than healthcare personnel.Conclusions:Participants used CAM modalities along with the conventional health care practices.Further multicentre studies should be conducted to provide information regarding the usage of CAM therapies and their eventual benefits in patients with cancer.

关键词： Alternative medicine Cancer patients complementary medicine Cross-sectional study

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Consensus views on competencies and teaching methods for an interprofessional curriculum on complementary and integrative medicine:A Delphi study

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Journal of Integrative medicine 2021年第3期19卷 282-290页

作者： Angelika Homberg Katja Krug Nadja Klafke Katharina Glassen Cornelia Mahler Svetla Loukanova Department of General Practice and Health Services Research University Hospital HeidelbergHeidelberg69120 HeidelbergGermany Department of Nursing Science University Hospital Tübingen72076 TubingenGermany

Objective:A collaborative team is necessary to help patients achieve their healthcare goals using complementary medicine.At present,healthcare professionals do not feel sufficiently qualified to provide this service.This study sought to identify competencies and teaching methods for interprofessional training on complementary and integrative medicine at medical schools.Methods:Sixty-five German-speaking experts with various professional backgrounds were invited to take part in a three-round Delphi study.In the first round,predefined competencies were assessed on a seven-point Likert scale,and participants were invited to propose additional competencies that would be evaluated in the subsequent rounds.The competencies were ranked based on the participant assessments and were assigned to four relevance groups.In the second and third rounds,suitable teaching methods were identified using free-text fields and multiple-choice questions.In a final workshop,participants synthesized the outcomes of the previous sessions and derived key competencies that would be a benefit to undergraduate interprofessional training in complementary and integrative medicine at medical schools.Results:The three rounds plus final worksop were attended by 50,40,36 and 11 experts.The competencies that these experts determined to be highly relevant to teaching complementary and integrative medicine emphasized,in particular,the respectful treatment of patients and the importance of taking a medical history.From these highly relevant competencies,three key targets were agreed upon in the final workshop:students are able to 1)classify and assess complementary medical terms and methods;2)work collaboratively and integrate patients into the interprofessional team;3)involve patients and their relatives respectfully and empathetically in all healthcare processes.To achieve these competency goals,the following teaching methods were highlighted:students discuss therapy options based on authentic patient cases with each other and practice empathic patie

关键词： Undergraduate education Interprofessional education complementary medicine Delphi study Curriculum Competency

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A cross-sectional study of complementary and alternative medicine use in patients with coagulation disorders in Southern Iran

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Journal of Integrative medicine 2017年第5期15卷 359-364页

作者： Mohammadreza Bordbar Mehdi Pasalar Rezvan Aresehiri Sezaneh Haghpanah Soheila Zareifar Fatemeh Amirmoezi Hematology Research Center Shiraz University of Medical SciencesShiraz ***Iran Research Center for Traditional Persian medicine and History of medicine Shiraz University of Medical SciencesShiraz ***Iran

OBJECTIVE：complementary and alternative medicine（CAM）use has an increasing trend around the world.Despite the wild application of CAM in patients with coagulation disorders,its efficacy is still questioned by many studies.The aim of this study was to determine the frequency and types of CAM usage,and the factors affecting CAM use among patients with bleeding disorders.METHODS：This cross-sectional study investigated the usage of CAM with a standard validated questionnaire in coagulopathic patients who were referred to Dastgheib Hospital,an educational therapeutic center affiliated to the Shiraz University of Medical Sciences in Shiraz,Southern Iran.RESULTS：Between December 2015 and May 2016,75 patients were included in this survey.Severe hemophilia A and rare bleeding disorders were the most frequent among our participants.Overall,nearly half of the studied population（49.3%）used at least one CAM product or practices.The most common products were multivitamin（29.3%）,followed by folic acid（21.3%）and chamomile（12%）.32%of the patients resorted to faith healing.The main reasons of using CAM were reported to be increased general health,correction of anemia and thrombocytopenia and control of bleeding tendency.CONCLUSION：CAM is being used frequently in patients with coagulation disorders like many other chronic illnesses all around the world.Due to emerging concern regarding the safety and possible interaction with the conventional medicine,it is necessary to develop basic data about the hematologic effects of these methods in order to use them more safely.

关键词： medicine, traditional complementary medicine alternative therapies coagulation disorder hemophilia Iran

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Chinese medicine as complementary Therapy for Female Infertility

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Chinese Journal of Integrative medicine 2017年第4期23卷 245-252页

作者： XIA du-feng Yoshinori Inagaki ZHANG Jian-feng WANG Ling SONG Pei-pei Graduate School of medicine The University of Tokyo Tokyo 113-8655 Japan Laboratory for Reproductive Immunology Hospital & Institute of Obstetrics and Gynecology Fudan University Shanghai Medical College Shanghai 200011China Academy of Integrated Traditional Chinese and Mordern medicine of Fudan University Shanghai 200011China Graduate School of Frontier Sciences The Universityof Tokyo Kashiwa-shi 227-8561 Japan

Chinese medicine (CM) has been used in clinical treatment for thousands of years in China, Japan, Korea, and other countries. CM is at present attracting many attentions around the world for reproductive health care and disease prevention, including treatment of female infertility. This review focuses on the CM treatment for female infertility patients, and supplies a summary on the efficacy, safety, and mechanism of some Chinese herbal medicines, herbal medicine-derived active compounds, and acupuncture. A large number of researches have reported that CM could alleviate or even cure female infertility by regulating hormone, improving reproductive outcome of in vivo fertilization, affecting embryonic implantation, curing polycystic ovarian syndrome, endometriosis, pelvic inflammatory disease, relieving mental stress, and regulating immune system. Meanwhile, a few studies claimed that there was little adverse reaction of CM in randomized controlled trials. However, up to present there is a lack of adequate evidences with molecular mechanistic researches and randomized controlled trials to prove the CM as an effective and safe treatment for infertility. Thus, utility of CM as a complementary medicine will be a feasible method to improve the outcome of female infertility treatment.

关键词： female infertility complementary medicine Chinese medicine combination therapy

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Prevalence and Determinants of Traditional,complementary and Alternative medicine Provider Use among Adults from 32 Countries

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Chinese Journal of Integrative medicine 2018年第8期24卷 584-590页

作者： Karl Peltzer Supa Pengpid Southeast Asian Nations (ASEAN) Institute for Health Development Mahidol University Department of Research and Innovation University of LimpopoTurfloop Campus HIV/AIDS/STIs and TB (HAST) Human Sciences Research Council

Objective： To estimate recent prevalence data（2011-2013） on traditional,complementary and alternative medicine（TCAM） provider use and sociodemographic and health related correlates in nationally representative population samples from 32 countries from all world regions.Methods： This secondary analysis was based on the International Social Survey Program（ISSP）,2011-2013,Health and Health Care Module.In a cross-sectional population-based survey（N=52,801）,simple or multi-stage stratified random sampling was used,resulting in representative samples of the adult population of respective countries.Results： Overall,the 12-month TCAM provider use prevalence was 26.4%,ranging from under 10% in Bulgaria,Poland and Slovenia to over 50% in China mainland,the Philippines and Republic of Korea.Over 80% TCAM treatment satisfaction was found in Europe in Denmark,Slovenia,Spain and Switzerland,in Asia in Taiwan（China） and USA.Multivariate logistic regression found sociodemographic variables（middle age,female sex,lower educational status,not having a religious affiliation,and lower economic indicators） and health variables（perceived poor or fair health status,being unhappy and depressed,having a chronic condition or disability,and having positive attitudes towards TCAM） were associated with TCAM provider use.Conclusions： A high prevalence TCAM provider use was found in all world regions and several sociodemographic and health related factors of its use were identified.

关键词： utilization traditional complementary medicine Africa Asia America Australia Europe

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Use of complementary and alternative medicine in pregnant women:A cross-sectional survey in the south of Iran

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Journal of Integrative medicine 2019年第6期17卷 392-395页

作者： Naghmeh Yazdi Alireza Salehi Mina Vojoud Mohammad Hossein Sharifi Ayda Hoseinkhani Research Center for Traditional medicine and History of medicine Shiraz University of Medical Sciences71348-14336 ShirazIran Student Research Committee Shiraz University of Medical Sciences71348-14336 ShirazIran

Objective: The use of traditional medicine and complementary alternative medicine(TM/CAM) derived from herbal remedies or natural supplements is increasing worldwide, but there are limited data on the use of TM/CAM during pregnancy. Iran has various ethnic populations, and the usage of TM/CAM by the different ethnic groups has not been researched. The aim of this study is to understand the use of TM/CAM modalities in pregnant women of different ethnic groups in southern Iran.Methods: This study was conducted in primary health care centers in Khuzestan Province, Iran, from May to August, 2016. A semi-structured valid questionnaire was used to gather information in pregnant women(n = 170).Results: About 46.5% of women in this study used TM/CAM during previous pregnancies. The majority(67%) of study participants were Arab. The Arab population showed increased use of TM/CAM during pregnancy(P = 0.014). Women with complications in former pregnancies had significantly higher incidence rate of TM/CAM use(65.8%) compared to the other group(39.6%)(P = 0.001).Conclusion: Understanding TM/CAM use and the associated factors in different ethnic groups of pregnant women will benefit the evaluation of the proper health policies and mother-infant health programs. This study contributes to the growing literature on TM/CAM, ethnic diversity and pregnant women.

关键词： Pregnancy complementary medicine Traditional medicine Alternative medicine

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Using simulation in complementary medicine education:an overview of clinical trials

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TMR Integrative medicine 2022年第14期6卷 1-6页

作者： Tamer Aboushanab Saad Baslom Monear Qoqandi Department of complementary medicine Saudi German HealthJeddah 23521Saudi Arabia.

Backgroundand Aim:Using simulation in learning medical interventions is a common practice.Simulation techniques provided a safe environment for trainees and students to acquire clinical skills and knowledge to practice in a real clinical environment.The aim of this review is to assess the use of health simulation in the field of complementary medicine education.Methods:Three medical databases were searched from inception to 15 November 2021.The inclusion criteria were clinical trials that used simulation in the field of complementary medicine training and in English language and the full text can be retrieved.Results:After searching,495 articles were retrieved,235 articles were excluded for duplication and 249 articles were excluded after screening of titles/abstracts and applying inclusion and exclusion criteria.Finally,11 articles were included in this review.These clinical trials had 719 participants and reported positive impact of using simulation in complementary medicine education.Conclusion:Simulation wasused for training of some complementary medicine therapies such as chiropractic,acupuncture,massage therapy,cupping therapy and osteopathy.Using simulation in complementary medicine education is recommended to ensure a safe environment for training.Conducting high quality clinical trials to evaluate the use of simulation in complementary medicine education is highly recommended.

关键词： simulation chiropractic acupuncture cupping therapy osteopathy complementary medicine

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Use of complementary and Alternative medicine in Siblings of Pediatric Cancer Patients in Germany.A Population-Based Survey

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Open Journal of Pediatrics 2014年第1期4卷 93-101页

作者： Sven Gottschling Sascha Meyer Alfred Langler Friedrich Ebinger Patric Bialas Benjamin Gronwald Centre of Palliative Care and Pediatric Pain Saarland UniversityHomburgGermany University Children’s Hospital Department of Neonatology and Pediatric Intensive Care MedicineSaarland UniversityHomburgGermany Gemeinschaftskrankenhaus Herdecke Department of integrative Pediatric and Adolescent MedicineHerdeckeGermany Witten/Herdecke University Faculty of HealthCenter for integrative MedicineWittenGermany St.Vincenz-Krankenhaus Paderborn Department of PediatricsPaderbornGermany University Children’s Hospital HeidelbergGermany Department of Anaesthesiology Intensive Care and Pain MedicineSaarland University HospitalHomburgGermany

Use of complementary and alternative medicine (CAM) in children with cancer is common and probably increasing. However data concerning use of CAM in siblings of children with an oncologic disease are missing so far. We conducted a population-based survey over a one-year period with 233 participants. Of the 209 respondents (90% response rate) 20% reported CAM use from the time on when the sibling was diagnosed to have cancer, compared to a prevalence rate of 48% before cancer diagnosis. The most prevalent therapies were homeopathy, anthroposophic medicine and Bach flowers. The main reasons for use were to strengthen the immune system and to achieve physical stabilization. Socio-demographic factors associated with CAM use were higher parental education and higher family income. A majority of CAM users would recommend them. 66% of the users informed a physician about CAM use. No side effects were reported.Conclusions: There is a significant decrease in CAM use in siblings of pediatric cancer patients after ascertainment of cancer in the affected sibling. Being out of the focus seems to be the main reason for non-use. Nevertheless the 20% CAM users rate CAM as very effective and would recommend CAM use to other parents.

关键词： complementary medicine Cancer Children Siblings

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To “tell or not to tell”——Exploring disclosure about medicine use by people living with sleep disorders

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Journal of Integrative medicine 2022年第4期20卷 338-347页

作者： Vibha Malhotra Joanna Harnett Erica McIntyre Amie Steel Keith Wong Bandana Saini School of Pharmacy Faculty of Medicine and Healththe University of SydneySydneyNew South Wales 2006Australia The Australian Research Centre in complementary and Integrative medicine School of Public Healththe University of TechnologySydneyNew South Wales 2007Australia Institute for Sustainable Futures the University of TechnologySydneyNew South Wales 2007Australia The Woolcock Institute of Medical Research the University of SydneySydneyNew South Wales 2037Australia Sydney Medical School Faculty of Medicine and Healththe University of SydneySydneyNew South Wales 2006Australia Department of Respiratory&Sleep medicine Royal Prince Alfred HospitalCamperdownNew South Wales 2050Australia

Objective: To explore the difference in rates and reasons for disclosure of either conventional or complementary medicine(CM) to healthcare practitioners between people living with sleep disorders(SDs) and those without SDs.Methods: A cross-sectional survey(N = 2019 adults) that measured sociodemographic characteristics,health status, health service utilisation, health literacy and health communication(medicine disclosure)of a representative sample of Australians was conducted. Data from participants reporting an SD(n = 265)were compared to those not reporting an SD to assess measures of health communication and disclosure about medicine use.Results: Overall, rates of medicine disclosure to both conventional and CM practitioners were high, in respondents with(70%) and without an SD(57%). Those reporting an SD had higher expectations of their conventional health practitioner’s knowledge of CM, associated clinical decision-making skills, and approval of CM use, and held a higher degree of concern about drug interactions(P medicine use to CM practitioners were “I want them to fully understand my health status” and“I was concerned about drug interactions with the CMs used.”Conclusion: The high rate of medicine use disclosure by people with SDs is driven by an intention to inform their healthcare practitioner about their health status and concerns about potential medicine interactions. Therefore, research about the expectations that people with an SD have of their conventional healthcare practitioners’ knowledge of CM and CM-drug interactions requires further examination.Likewise, further examination of CM practitioner’s conventional medicine knowledge is encouraged.

关键词： medicine disclosure complementary medicine Drug interactions Sleep disorder Patient safety Cross-sectional survey

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Anti-tumour activity and toxicological studies of combination treatment of Orthosiphon stamineus and gemcitabine on pancreatic xenograft model

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World Journal of Gastroenterology 2022年第32期28卷 4620-4634页

作者： Ashwaq Hamid Salem Yehya Ayappa V Subramaniam Muhammad Asif Gurjeet Kaur Amin M S Abdul Majid Chern Ein Oon Institute for Research in Molecular medicine Universiti Sains MalaysiaPenang 11800Malaysia Cancer Research Eman BiodiscoveriesKedah 08000Malaysia Department of Pharmacology Faculty of PharmacyThe Islamia University of BahawalpurPunjab 63100Pakistan Department of Cancer Biology and Therapeutics The John Curtin School of Medical ResearchAustralia 2601Australia

BACKGROUND Pancreatic cancer is the most aggressive cancer type.Gemcitabine is the first line chemo-drug used for pancreatic cancer but exerts a broad spectrum of organ toxicities and adverse effects in patients.AIM To evaluate the anti-tumour activity and toxicological effects of Orthosiphon stamineus extract formulation(ID:C5EOSEW5050ESA trademarked as Nuvastatic^(TM)),and gemcitabine combination on pancreatic xenograft model.METHODS Mice were randomly divided into six groups of 6 mice each(n=6)and given different treatments for 28 d.The study design consisted of a 2 x 3 factorial treatment structure,with gemcitabine(yes/no)by oral(at 1200 and 400 mg/kg per day).Human pancreatic cancer cells were injected subcutaneously into the flanks of athymic nude mice.C5EOSEW5050ESA(200 or 400 mg/kg per day)was administered orally,while gemcitabine(10 mg/kg per 3 d)was given intraperitoneally either alone or in combination treatment.Histopathological analyses of vital organs,tumour tissues,and incidence of lethality were analysed.Analyses of tumour necrosis and proliferation were determined by haematoxylin-eosin staining and immunohistochemistry for Ki-67,respectively.RESULTS No signs of toxicity or damage to vital organs were observed in all treatment groups compared to the untreated group.C5EOSEW5050ESA at 200 mg/kg and gemcitabine combination had no additive antitumor effects compared to a single treatment.Remarkably,a comparably greater response in a reduction in tumour growth,Ki-67 protein expression,and necrosis was demonstrated by 400 mg/kg of C5EOSEW5050ESA and gemcitabine combination than that of the individual agents.CONCLUSION These results highlighted the synergistic activity of C5EOSEW5050ESA with gemcitabine to reduce pancreatic tumour growth in mice compared to a single treatment.Thus,this study provides valuable insights into using C5EOSEW5050ESA as a complementary treatment with gemcitabine for pancreatic cancer.

关键词： Pancreatic cancer Orthosiphon stamineus C5EOSEW5050ESA Gemcitabine complementary medicine

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